Care of the Child With Ebola Virus Disease Objectives: To provide clinicians with practical considerations for care of children with Ebola virus disease in resource-rich settings. Data Sources: Review of the published medical literature, World Health Organization and government documents, and expert opinion. Data Synthesis: There are limited data regarding Ebola virus disease in children; however, reported case-fatality proportions in children are high. … Continue reading “Care of the Child With Ebola Virus Disease” Learn More
The Medical Home and Care Coordination in Disaster Recovery: Hypothesis for Interventions and Research In postdisaster settings, health care providers encounter secondary surges of unmet primary care and mental health needs that evolve throughout disaster recovery phases. Whatever a community’s predisaster adequacy of health care, postdisaster gaps are similar to those of any underserved region. We hypothesize that existing practice and evidence supporting medical homes and care coordination in … Continue reading “The Medical Home and Care Coordination in Disaster Recovery: Hypothesis for Interventions and Research” Learn More
Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event Objective: ICU resources may be overwhelmed by a mass casualty event, triggering a conversion to Crisis Standards of Care in which critical care support is diverted away from patients least likely to benefit, with the goal of improving population survival. We aimed to devise a Crisis Standards of Care triage allocation scheme specifically for children. … Continue reading “Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event” Learn More
System-Level Planning, Coordination, and Communication: Care of the Critically Ill and Injured During Pandemics and Disasters: CHEST Consensus Statement System-level planning involves uniting hospitals and health systems, local/regional government agencies, emergency medical services, and other health-care entities involved in coordinating and enabling care in a major disaster. We reviewed the literature and sought expert opinions concerning system-level planning and engagement for mass critical care due to disasters or pandemics and offer suggestions for system-planning, … Continue reading “System-Level Planning, Coordination, and Communication: Care of the Critically Ill and Injured During Pandemics and Disasters: CHEST Consensus Statement” Learn More
Would Triage Predictors Perform Better than First-Come-First-Served in Pandemic Ventilator Allocation? In a pandemic, needs for ventilators might overwhelm the limited supply. Outcome predictors have been proposed to guide ventilator triage allocation decisions. However, pandemic triage predictors have not been validated. This quantitative simulation study evaluated outcomes resulting from allocation strategies varying in their performance for selecting short stay survivors as favorable candidates for ventilators. A … Continue reading “Would Triage Predictors Perform Better than First-Come-First-Served in Pandemic Ventilator Allocation?” Learn More
Disaster-Related Environmental Health Hazards: Former Lead Smelting Plants in the United States Natural disasters exacerbate risks of hazardous environmental exposures and adverse health consequences. The present study determined the proportion of previously identified lead industrial sites in urban locations that are at high risk for dispersal of toxic chemicals by natural disasters. Geographic analysis from publicly available data identified former lead smelting plants that coincide with populated … Continue reading “Disaster-Related Environmental Health Hazards: Former Lead Smelting Plants in the United States” Learn More
School Interventions After the Joplin Tornado Background/Objective To qualitatively describe interventions by schools to meet children’s needs after the May 2011 Joplin, Missouri tornado. METHODS: Qualitative exploratory study conducted six months after the tornado. Key informant interviews with school staff (teachers, psychologists, guidance counselor, nurse, principal), public health official, and physicians. Report After the tornado, school staff immediately worked to contact … Continue reading “School Interventions After the Joplin Tornado” Learn More
Development of Functional Symptoms in Children Exposed to Traumatic Events This chapter will review the typical symptoms occurring in children after stressful traumatic exposures. Unlike other chapters in this book, no specific organ system is the most likely focus of functional symptoms in this setting. Psychological distress may exacerbate symptoms of physical illness and injury associated with the traumatic events, may be expressed as almost … Continue reading “Development of Functional Symptoms in Children Exposed to Traumatic Events” Learn More
Surge Capacity Logistics Successful management of a pandemic or disaster requires implementation of preexisting plans to minimize loss of life and maintain control. Managing the expected surges in intensive care capacity requires strategic planning from a systems perspective and includes focused intensive care abilities and requirements as well as all individuals and organizations involved in hospital and regional … Continue reading “Surge Capacity Logistics” Learn More
Regional Variation in Critical Care Evacuation Needs for Children After a Mass Casualty Incident To determine the ability of five New York statewide regions to accommodate 30 children needing critical care after a hypothetical mass casualty incident (MCI) and the duration to complete an evacuation to facilities in other regions if the surge exceeded local capacity. A quantitative model evaluated pediatric intensive care unit (PICU) vacancies for MCI patients, … Continue reading “Regional Variation in Critical Care Evacuation Needs for Children After a Mass Casualty Incident” Learn More
The 2011 Tuscaloosa Tornado: Integration of Pediatric Disaster Services into Regional Systems of Care Objective: To empirically describe the integration of pediatric disaster services into regional systems of care after the April 27, 2011, tornado in Tuscaloosa, Alabama, a community with no pediatric emergency department or pediatric intensive care unit and few pediatric subspecialists. Study design: Data were obtained in interviews with key informants including professional staff and managers … Continue reading “The 2011 Tuscaloosa Tornado: Integration of Pediatric Disaster Services into Regional Systems of Care” Learn More
